Trump budget would cut $636 billion from HHS agencies

As part of his $4 trillion budget for next year, President Donald Trump is proposing a $636 billion cut in federal funding for CMS programs over the next decade. Those cuts would make room for more spending on defense and border security. […]

Trump’s budget targets the National Institutes of Health, though Congress made it clear that it’s willing to spend on medical research, adding $2 billion to NIH funding when Trump had suggested a $1.2 billion cut in the remainder of 2017.

For 2018, HHS continues to recommend a cut of $5.8 billion, with the biggest cuts in the National Cancer Instute, at $1 billion; National Institute of Allergy and Infectious Diseases, at about $840 million; and National institute of Diabetes & Digestive & Kidney Diseases at $355 million.

The National Cancer Institute was particularly favored by appropriators earlier this month, with a $476 million increase.

HHS seeks to reduce how much labs can put towards overhead, such as fringe benefits, utilities and buying lab equipment. On average, labs get 30% of the total grant for overhead, higher than the overhead percentage from private funders.

The budget said: “NIH will implement reforms to release grantees from the costly and time-consuming indirect rate setting process and reporting requirements. Applying a uniform indirect cost rate to all grants mitigates the risk for fraud and abuse because it can be simply and uniformly applied to grantees. The Budget includes this critical reform to reduce indirect costs and preserve more funding for direct science.”

The budget did not say what that overhead amount would be, however.

It’s not just overhead that would fall in the unlikely case that Congress passed this plan. The Trump draft budget would eliminate 1,648 in 2018 for a total of 7,326 for the year.

Diana Zuckerman, president of the National Center for Health Research, does not expect Congress, which was generous to the institutes earlier this month, to support Trump’s cuts.

“I have never known Congress that enthusiastically cut NIH funding,” she said.

But she’s less sanguine about the fate of the Centers for Disease Control and Prevention, which would be cut by $1.3 billion, or just over 20%, in this budget.

Congress loves NIH, but she said, “they don’t realize, whether it’s CDC or AHRQ (Agency for Healthcare Research and Quality), that they have a very important role to play.”

AHRQ is zeroed out in the Trump budget, but NIH would receive $272 million to carry out similar initiatives. […]